Provider Demographics
NPI:1376785782
Name:BROWN, ONNIE MARIA (APRN)
Entity type:Individual
Prefix:MISS
First Name:ONNIE
Middle Name:MARIA
Last Name:BROWN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ONNIE
Other - Middle Name:MARIA
Other - Last Name:BROWN-SHELLMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:16220 N 7TH ST
Mailing Address - Street 2:APT. 2327
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-2600
Mailing Address - Country:US
Mailing Address - Phone:912-655-0819
Mailing Address - Fax:
Practice Address - Street 1:6514 MEADOWRIDGE RD
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6115
Practice Address - Country:US
Practice Address - Phone:623-466-3106
Practice Address - Fax:623-566-1802
Is Sole Proprietor?:No
Enumeration Date:2009-03-31
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP8302363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health